Theory and Clinical Practice in Pediatrics

Vitamin D Status and Associated Factors among Children and Adolescents with Epilepsy in the Watsa Health Zone, Democratic Republic of the Congo

2026-07-15T15:47:36+08:00

Background: Vitamin D deficiency has been increasingly recognised among children and adolescents with epilepsy, particularly in low-resource settings, where disease-related factors, antiepileptic treatments, and nutritional deficiencies may contribute to reduced serum levels. This study aimed to assess vitamin D status and identify associated factors in children and adolescents with epilepsy in Watsa health zone, Democratic Republic of the Congo. Methods: A cross-sectional study was conducted among 43 children and adolescents with epilepsy. Sociodemographic, clinical, nutritional, and treatment-related data were collected. Serum 25-hydroxyvitamin D [25(OH)D] and calcium levels were measured. Associations were explored using bivariate analyses, correlation tests, and multivariable linear regression models. Results: The mean age was 11.2 ± 6.3 years, and 55.8% were male. Most participants (60.5%) had uncontrolled seizures. Vitamin D insufficiency was highly prevalent (69.8%), while 25.6% had deficiency; only 4.7% had normal levels. Mean serum 25(OH)D was 23.5 ± 4.3 ng/mL. In bivariate analysis, fish (p = 0.002), milk (p < 0.001), and egg consumption (p = 0.013) were associated with higher vitamin D levels. No associations were found with age, sex, epilepsy characteristics, treatment, or calcium levels. In multivariable analysis, fish (β = 6.51; p < 0.001), milk (β = 4.32; p = 0.001), and eggs (β = 3.62; p = 0.004) remained independent predictors of higher serum 25(OH)D. Conclusion: Vitamin D insufficiency is highly prevalent among children and adolescents with epilepsy in Watsa health zone. Dietary intake of fish, milk, and eggs appears to be the main modifiable determinant of serum 25(OH)D levels, highlighting the importance of targeted nutritional interventions in this population.

Playful Adaptation of the Forced Expiratory Technique in Children: A Mechanism-Based Conceptual Framework for Airway Clearance

2026-06-08T12:21:15+08:00

Objective: To propose and analyze a playful adaptation of the Forced Expiratory Technique (FET) in children based on a mechanism-oriented framework for airway clearance.
Methods: This is a descriptive theoretical-conceptual study based on the development and analysis of a pediatric clinical protocol incorporating playful strategies into FET execution. The components of the technique were mapped to their underlying physiological mechanisms according to contemporary classifications of airway clearance techniques.
Results: The proposed model suggests that the playful adaptation of FET is theoretically capable of activating key physiological mechanisms involved in airway clearance, including airflow modulation, increased lung volumes, and secretion mobilization. The integration of these components supports a multimodal physiological approache.
Conclusion: The playful adaptation of FET may represent a feasible and physiologically grounded strategy to enhance adherence and facilitate the execution of therapeutic breathing patterns in pediatric patients.

Integrative Traditional Chinese and Western Medicine in the Management of Pediatric COVID-19: A Systematic Review

2025-11-05T13:39:32+08:00

The coronavirus disease 2019 (COVID-19) pandemic has posed unique challenges to pediatric healthcare worldwide, given children's distinct physiological characteristics and variable clinical manifestations. Integrative Traditional Chinese and Western Medicine (TCM-WM) has emerged as a pivotal therapeutic paradigm in pediatric COVID-19 management, leveraging WM's precision in pathogen control and organ support with TCM's holistic syndrome-based regulation. This review systematically synthesizes the latest evidence (up to 2025) on pediatric COVID-19 from dual medical perspectives, including epidemiological features, pathological mechanisms, stage-specific integrative therapeutic strategies, and mechanistic insights. We prioritize evidence from Chinese core journals in TCM and integrative medicine, supplemented by landmark studies from prestigious international SCI journals. Special emphasis is placed on pediatric-specific syndrome differentiation, age-adapted interventions, and management of unique complications such as multisystem inflammatory syndrome in children (MIS-C). Finally, we discuss current limitations in standardization and evidence quality, and propose future research directions tailored to pediatric populations. This review aims to provide evidence-based guidance for clinicians practicing integrative pediatric medicine and contribute to the optimization of global pediatric COVID-19 care protocols.

Child Abuse in the School Setting in the DRC: A Multidimensional Analysis, Psychosocial Impacts, and Pathways to Integrated Prevention

2025-07-25T14:21:59+08:00

In recent years, the virality of videos depicting various forms of abuse in Congolese schools has exposed an alarming issue, raising questions not only about pedagogical dynamics but also the sociocultural foundations of child protection. This article offers a critical analysis of the systemic determinants of child abuse within the Congolese educational context, examining its neurocognitive, psychosocial, and economic repercussions. Drawing on an interdisciplinary literature review (encompassing pedagogy, public health, and human rights), it develops a theoretical framework for structural reforms centered on primary prevention and restorative justice.

Prevalence of Abdominal Obesity and Associated Factors Among Secondary School Students in Kisangani, DRC: A Cross-Sectional Study

2025-06-20T16:45:10+08:00

Background: Adolescent obesity is a growing public health concern globally, including in sub-Saharan Africa. This study aimed to assess the prevalence and associated factors of abdominal obesity among school-aged adolescents in Kisangani, Democratic Republic of Congo (DRC).
Methods: We conducted a cross-sectional descriptive study from October to December 2023 in 15 secondary schools across five communes of Kisangani. A total of 1,416 students aged 11 to 18 years were enrolled. Data were collected using structured interviews and anthropometric measurements. Abdominal obesity was defined according to the International Diabetes Federation (IDF) 2007 pediatric criteria. Bivariate analyses were performed to identify associated factors.
Results: The overall prevalence of abdominal obesity was 12.35%, with a significantly higher rate in girls (15.83%) than in boys (3.10%). Key associated factors included female sex (OR = 5.85; p < 0.0001), sedentary behavior (watching TV > 3 hours/day), use of motorized transport to school, frequent meat consumption, and having three or more meals per day. Co-occurrence of other metabolic risk factors such as elevated triglycerides, high fasting glucose, and low HDL-C was observed in up to 2.33% of adolescents, meeting the criteria for metabolic syndrome.
Conclusion: Abdominal obesity and its associated risk factors are prevalent among adolescents in Kisangani, especially among girls. Immediate public health interventions focused on nutrition, physical activity, and lifestyle habits are essential to curb the rising trend of adolescent obesity in urban areas of the DRC.

Knowledge, Attitudes, and Perceptions of Healthcare Providers Regarding Sickle Cell Disease and Its Newborn Screening in Mbuji-Mayi, DRC

2025-06-12T16:27:45+08:00

Background: Sickle Cell Disease (SCD) remains a major public health issue in sub-Saharan Africa. Newborn screening (NBS) programs are crucial for early diagnosis and improved survival. However, their effectiveness depends largely on healthcare providers’ knowledge, perceptions, and attitudes. This study assessed these aspects among providers in Mbuji-Mayi, Democratic Republic of the Congo.
Methods: A cross-sectional analytical study was conducted among 191 healthcare providers selected by stratified random sampling. Data were collected using a structured questionnaire and analyzed with STATA version 16. Descriptive statistics were used to summarize participant characteristics. Bivariate and multivariate logistic regression analyses were performed to identify determinants associated with knowledge of SCD.
Results: The median age of respondents was 29 years, with a predominance of females (71.20%). Most participants had a secondary or higher education level (97.38%) and were nurses (56.54%). About 76.44% had heard of SCD, mainly through television (64.38%) and radio (20.55%). Regarding attitudes, 74.66% believed in the importance of screening and supported early testing, while 98.95% favored referring newborns with SCD to hospitals. Perceptions revealed strong cultural beliefs: 82.20% associated SCD with mysticism or diabolical causes. Bivariate analysis showed that knowledge of SCD and its NBS was significantly associated with profession (crude OR = 36.30), prior examine SCD patients (crude OR = 36.00), and education level (crude OR = 14.15). In the multivariate model, two factors remained independently associated with adequate knowledge: being a medical doctor (adjusted OR = 23.382; 95% CI: 3.097–176.550; p = 0.0022) and having prior experience examining a patient with SCD (adjusted OR = 29.154; 95% CI: 3.584-237.150; p = 0.0016).
Conclusion: While awareness of SCD and its NBS among healthcare providers in Mbuji-Mayi is relatively high, significant misconceptions and cultural beliefs persist. Professional category and clinical experience with SCD are key determinants of knowledge. These findings highlight the need for targeted training and sensitization to strengthen early screening practices and address sociocultural barriers.

Bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa: About a systematic review and critical reading of the literature

2024-10-19T20:25:28+08:00

Objective : Bacterial meningitis is a serious, urgent, debilitating and fatal disease. It is therefore necessary to have data on bacterial epidemiology and the profile of sensitivity to antibiotics on which the emergency treatment protocol could be based. The objective of this study was to identify the bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa by conducting a systematic review of recent literature.
Methods : This is a systematic review of the literature for which we visited free databases including PubMed, Cochrane, Medline, Google scholar and PMC Free. The key words used were: bacterial meningitis, Sub-Saharan Africa, Acute bacterial meningitis; Culture; Gram stain; Incidence, meningitis; pneumococcus; Haemophilus influenzae. Our research considered articles conducted in sub-Saharan Africa, of all languages, and published since 2004. In total, the search generated 48 studies, which after applying the criteria mentioned above, only 7 studies were retained.
Results : This systematic review showed that the bacterial flora during meningitis in children aged between 3 months to 15 years is essentially dominated by Streptococcus pneumonia in the majority with a weighted frequency of 42.9% (35.2-47. 4) and significant heterogeneity between different authors (p < 0.001). This was followed by Haemophilus influenzae with a weighted frequency of 13.8% (11.3-18.1). Escherichia coli and meningococci were observed in a small proportion. The germs identified were more sensitive to cefotaxime, ceftriaxone, then to amoxicillin, gentamicin and oxacillin.
Conclusion : Studies are necessary to regularly revisit the bacterial flora during meningitis in children in order to adapt the treatment according to the antibiogram and for probabilistic antibiotic therapy to be based on research results, because this flora bacterial infection varies from one period to another and from one country to another.

Social perceptions of childhood diarrhea in Lubumbashi, Democratic Republic of the Congo: A qualitative study

2024-10-01T20:19:17+08:00

Introduction: Infantile diarrhea remains a public health problem in the Democratic Republic of the Congo, where infant mortality linked to this disease remains high despite the proven efficacy of oral rehydration therapy. This study aims to understand the social perceptions of childhood diarrhea among mothers in Lubumbashi, by examining how they diagnose and treat the disease through both popular and biomedical representations.
Material and methods: The study was conducted in Lubumbashi, the capital of Haut-Katanga in the DRC, utilizing a qualitative methodology that involved semi-structured interviews with 32 randomly chosen mothers. Selection criteria encompassed the number of children, educational level, religion, and age range (18 to 60). Information was gathered through documents and interviews conducted in Swahili, subsequently translated into French, and analyzed utilizing Jean-Blaise Grize’s ‘natural logic’ to grasp social representations.
Results: The study revealed that the majority of mothers associated diarrhea with physical signs such as dehydration, watery stools, depressed fontanel, and sunken eyes. Several mothers attributed the diarrhea to cultural causes, such as the consumption of certain foods by pregnant women (e.g. “kabambale”) or the practice of breastfeeding by pregnant mothers. Local diseases such as “lukunga” and “kilonda ntumbo” are considered to be specific forms of diarrhea in popular culture. Treatments include traditional remedies such as ash applications and sitz baths.
Conclusion: Perceptions of childhood diarrhea in Lubumbashi reflect a tension between cultural beliefs and biomedical knowledge, where rehydration is often neglected. The study recommends raising community awareness of the effectiveness of ORT while respecting local beliefs.

Anencephaly: A case report and the crucial role of folic acid supplementation and early diagnosis

2024-04-27T15:35:18+08:00

Anencephaly is a congenital malformation caused by neural tube failure, which can be managed through folic acid intake during pregnancy. Diagnosis is typically prenatal, and termination of pregnancy is often recommended. A newborn born at Kolwezi paediatric clinic was born with a visible congenital malformation. The mother had a low socio-economic background and was 41 years old. An ultrasound scan revealed a progressing pregnancy at 30 weeks gestation with polyhydramnios. No antenatal care monitoring or folic acid prophylaxis was implemented during the periconceptional period and throughout the pregnancy. Anencephaly diagnosis was confirmed, and the newborn died five minutes post-birth. Preventive folic acid treatment has shown a decrease in neural tube defects, and first-trimester ultrasound scans can help identify life-incompatible congenital malformations. Advocating for legislative measures and genetic counselling is crucial to educate parents on recurrence risks and the advantages of folic acid supplementation before subsequent pregnancies.

Exploring quality of life disparities among 177 families with children affected by cleft lip and/or palate: A comprehensive analysis using the Impact on Family Scale

2024-04-27T17:00:08+08:00

Objective: This study aimed to assess the quality of life (QoL) of parents/caregivers of children with cleft lip and palate (CLP) using the Impact on Family Scale (IOFS).
Methods: Families of children requiring primary or secondary CLP repair were recruited based on the inclusion criteria. The IOFS questionnaire was utilized to assess perceived QoL. Multiple logistic regression was employed to determine factors linked to impacted QoL.
Results: Out of the 192 families contacted, 177 participated (92.2%). The patients had a mean age of 8.9 ± 5.4 months, with a majority of families residing in rural areas (67.2%). The questionnaires assessed QoL before surgery, revealing a mean total QoL score of 68.8 ± 19.4, with 49.7% of families experiencing affected QoL. The analysis demonstrated a significant association between the female sex of parents/caregivers and a more impacted QoL (p = 0.018), as well as between the absence of a history of CLP in the family and a more affected QoL (adjusted odds ratio = 3.0; 95% CI: 1.3 – 6.7; p = 0.008).
Conclusion: Caring for a child with CLP significantly decreases parents/caregivers’ QoL in all domains. The results emphasize the significance of considering the family history of CLP and the gender of the parents in the comprehensive care of affected families.